Issue link: https://beckershealthcare.uberflip.com/i/1412045
86 OPIOID REDUCTION Does opioid prescription monitoring lead patients to seek more dangerous alternatives? By Katie Adams I n June, Missouri became the 50th state to establish a statewide prescription drug monitoring program. How- ever, experts are still split over whether such programs effectively decrease opioid-related overdoses, Kaiser Health News reported July 26. Kentucky was the first state to require prescribers and dispensers to use a monitoring system. Shortly aer the state began using the system in 2012, the number of opioid prescriptions and overdoses from prescription opioids decreased slightly. However, overall opioid overdose deaths have been steadily increasing since 2012, with the exception of slight decreases in 2018 and 2019, according to CDC data. Some public health experts say prescription monitoring pro- grams force patients who have an addiction to turn to more dangerous alternatives, such as heroin and fentanyl. Others say the absence of such programs makes it easier for patients to visit different physicians to obtain prescriptions for the same drug and for providers to overprescribe. Stephen Wood, a nurse practitioner who is also a visit- ing substance abuse bioethics researcher at Cambridge, Mass.-based Harvard University, told Kaiser Health News prescription monitoring programs can oen make patients feel like they're in trouble without offering any viable treat- ment options. At Boston-based Carney Hospital, he and his colleagues rely more on toxicology screens signs such as injection marks on skin. "Rather than pulling out a piece of paper and being accusa- tory, I find it's much better to present myself as a caring provider and sit down and have an honest discussion," Mr. Wood said. Faisal Khan, PhD, the director of the health department in St. Louis County, Mo., told Kaiser Health News that while monitoring programs can lead to an increase in overdose deaths in the years immediately following their establish- ments they also help physicians intervene before a patient becomes addicted to opioids. He said physicians can direct patients to treatment pro- grams, but Rachel Winograd, PhD, who leads a program called NoMODeaths, said "we absolutely are not prepared for that in Missouri." Ms. Winograd told Kaiser Health News substance use treatment providers are oen at max capacity. n Seattle Children's hospital eliminates opioids at ASC By Alan Condon S eattle Children's hospital is seeing the benefits of elimi- nating opioids during surgery at its ASC in Bellevue, Wash., local news outlet KIRO 7 News reported July 20. Initially, the surgery center planned to reduce intraop- erative opioid use, but the ASC's medical director Lynn Martin, MD, an anesthesiologist, decided to remove them completely. "Nothing earth-shattering happened," according to Dr. Mar- tin, who said patients actually saw some advantages, includ- ing waking up faster post-surgery as well as less nausea and vomiting. The ASC used a combination of other drugs, without morphine or other opioids, for children undergoing tonsil- lectomies, hernia surgeries and procedures for sports injuries. Now, following the surgery center's success, the main hos- pital is reducing opioids during major surgeries, which has led to shorter stays and decreases the risk of addiction for young patients, according to the report. "I think it is a very positive step," Rosemary Orr, MD, an anes- thesiologist at Seattle Children's told KIRO 7 News. "Anything that reduces the amount of available opioids in the commu- nity is going to change things." n J&J stops distributing opioids in the US, pays New York $230M By Katie Adams J ohnson & Johnson confirmed confirmed it has ended its distribution of opioids in the U.S. when it agreed to a $230 million settlement with New York for its role in the opioid epidemic. The settlement, reached June 26, prohibits the company from promoting opioids through any means and bans lobbying about opioid products at the federal, state and local levels. The last time Johnson & Johnson marketed opioids in the U.S. was 2015, and the drugmaker said it discontinued its opioid business in 2020. To resolve claims that it fueled the opioid epidemic, Johnson & Johnson will pay New York $230 million over nine years. It will also pay an additional $30 million in the first year New York's executive chamber signs into law new legislation to create an opioid settlement fund. n